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HomeMy WebLinkAboutOpening of Bids - Erskine Clubhouse Renovation Proj No 116-108 - Ziolkowski ConstructionP 40 CITY OnNerF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK Project Name Erskine Clubhouse Renovation Project No, 116-108 For Bids Due J August 14, 2108 PART I (Must be completed for all bids. Please type or print) Date: August 14,2018 Bidder (Firm): Ziolkowski Construction, Inc. Address: 4050 Ralph Jones Drive City/State/Zip: South Bend, IN 46628 Telephone Number: ( 574 ) 287-1811 Agent of Bidder (if Applicable): n/a. Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: Erskine Clubbotise Renovation the City of South Bend, Indiana, in accordance with plans and specifications prepared by: Kil Arcl-atecture/Planning and dated 5/22/18 — for the sum of (enter the Total Bid as shown on the Proposal) 0" MZL\Qta�, FOA-�f &()CV�,00SaLk1 &-%Aak ($ 1 t 6 41.k.k.'706 -L (Enter sum of Total Base Bid plA Alternates shown on Proposal) (Niumerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material! included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend, If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. By 1&0 hAweo) (Signature) Bill Favors, President The above bid is accepted this Subject to the following conditions: Gary A. Gilot, President Elizabeth A. Maradik, Member James A. Mueller, Member (Printed Name of Person Signing) � �-- 2� day of Suzanna M. Fritzberg, Member Therese J. Dorau, Member Attest: Linda M. Martin, Clerk 20 Version 10/17/2017 Contractor's Bid for Public Works - 2 BID/PROPOSAL 01hubA #iw "y'r1wi Project Name Erskine Clubhouse Renovation Project No. 116-108 For Bids Due --4ufte-z �,� August 14, 2018 Item No. Description Quantity Unit Unit Price Total Amount 1 Building Renovation: (Interior) 1 LS ,C)66 2 Building Renovation (Exterior) 1 LS 65,000 65,0,00 3 Mechanical Plumbing 1 LS 4 Mechanical HVAC 1 LS 5 Electrical 1 LS 0 Opp 6 Exterior Site Work 1 LS 200,000 200,000 BASE BID TOTAL qorl, &Oe> ALTERNATE#1 Item No. Description Quantity Unit Unit Price Total Amount I Restroorn Expansion (Lower Level) 1 LS (voC) ALTERNATE #1 TOTAL 42.1 1 �600 I ALTERNATE#2 Item, No. Description Quantity Unit Unit Price Total Amount 1 Bar and Concessions (Lower Level) I LS 56)" 0001 S()1006 ALTERNATE #2 TOTAL 50160 0 Item No. Description Quantity Unit Unit Price Total Amount 1 North Porch Pendant Chandelier 1 LS 00 0 00 6 2 North Porch Wall Coach Lantern 2 LS 15 00 F 010 ALTERNATE #3 TOTAL 0 0 ALTERNATE#4 Item No. Description Quantity Unit Unit rice Total Amount North Porch Deck Railing and Piers 1 LS -1 oD ALTERNATE #4 TOTAL 9 1 -100 Version 10/1712017 Contractor's Rid for Public Works - 7 Item No. Description Quantity Unit Unit Price Total Amount 1 Main Level West Fireplace Insert 1 LS tip, 2 Lower Level East Fireplace Insert 1 LS ALTERNATE #5 TOTAL I F-11141 1411, Item No. Description Quantity Unit Unit Price Total Amount 1 2 Main Level Plaster Ceiling Repair Lower Level Plaster Ceiling Repair 350 100 SF SF 24 24 8,400 2,400 Main Level Plaster Wall Repair 250 SF 22 5,500 4 Lower Level Plaster Wall Repair 100 SF 22 2,200 ALTERNATE #6 TOTAL 183500 ALTERNATE #7 Description Unit Price Total Amount — --- - ------ Snack Bar Concessions ii ALTERNATE #7 TOTAL HMO ALTERNATE #8 If tm e No. Description Quantity Unit Unit Price Total Amount 1 Lower Level Floor Repair and Finishing 1 LS 10,000 MOW ALTERNATE #8 TOTAL 10,00!0 Item No. Description DEDUCTISF ADD/SF 1 Roof Deck Repair 5.75 7.00 2 Plaster Repair (Wall) 20 25 ]aster Repair (Ceilings) 20 25 Bidder (Firm): Address: City/State/Zip: TOTAL BASE BID PLUS ALTERNATES I t 0q&% 700 Ziolkowsld Construction, Inc. 4050 Ralphjones Drive South Bend, IN 46628 Telephone Number ( 574 ) 287-1811 -3 (Signature) Bill Favors, President (Printed Narne of Person Signing) Version 10/17/2017 Contractor's Bid for Public Works - 8 When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF Indiana } ) SS: StJosephCOUNTY } The undersigned Contractor, being duly sworn upon his/herlits oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § S-22-16.5-5, as amended from tone -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from tune -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/shcht shall enroll in and verify the work eligibility status of all of Contractor's Version 10/17/2017 Contractor's Bid for Public Works - 4 newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require hls/herfits subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term ofthe contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. 1, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a detennination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. Version 10/17/2017 Contractor's Bid for Public Works - 5 I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 14th day of August, 2018 Ziolkowski Construction. Inc. Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent Bill Favors, President Printed Name and Title Subscribed and sworn to before me this 14th day of Auaust 2018 My Commission Expires March 1, 2020 Ncil,(4� otary Public Shannon Rcidenbach County of Residence St SHANNON REIDENBA10H Notary Public- Seal State of Indiana My Gonnrnission Expires Mar 1, 2020 Version 10/17/2017 Contractor's Bid for Public Works - 6 MIto , " , 111i A i Project Name Erskine Clubhouse Renovation Project Prior 116-108 For Bids Due , August 14, 2108 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. X Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of United States Steel Products or Foundry Products. Proof of MBEANBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBENVBE Contacted X Form [MWBE-2.1]. X Acknowledge Receipt of 4 Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature, X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Ziolkowski Construction, Inc. Date: August 14, 2018 By Authorized Representative: Signature: Print Name& Title: Bill avors, President Version 10/17/2017 Contractor's Bid for Public Works - 1 (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/herlits bid. Please see attached Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) As directed by the Architect/Construction Manager 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. If Subcontractors will be used we will submit this information 24 hours after notification. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. If Subcontractors will be used we will submit this information 24 hours after notification. 4. Attach a listing of equipment you have available to use for the proposed project. Whatever is required to complete the project properly and on time. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. yes SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 10/17/2017 Contractor's Bid for Public Works - 3 1� p 0 c 0 M 0 CL mom, ILLI, I c lea 0, uJ 0 W 0 7;3 S Ci to cr a. 0 0 E .® 0- r 0 0 0 0 0 0 CL m 0 V 5 0 0 0 0 d) U M th 4a to I— = 0 E cc z a) 9 0 E nii 0 'A 0 i-V 0- M 0 OL 2 CfJ CL E 0 0 Eu kn t <W Go O. co cu CL o CA co 4) 'C� ®A 0 E E �7 CL w bi) cu LLJ w llz$ z u M M, z 15 a_ WE See News CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE/WBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration ("IDOA"). Project Number 116-108 Date: August 14, 2018 Project Name. Erskine Clubhouse Remodeling Bidder: Ziolkowski Construction, Inc. Contact Person: —Gary Paston Telephone: 574-287-1811 Address: 4050 Ralph Dories Drive City: South Bend State: Jridiaria Zip: 46628 Email., gpastoii@zbuild.com To determine whether a bidder has demonstrated good faith efforts to reach the MBE/WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith, Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBEtWBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business X Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in.gov/idoa). ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bird meetings scheduled by the City to inform MBEIWBEs of contracting and subcontracting opportunities. 2, Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBEIWBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated to inform MBEMBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively, 4. Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and! placement of MBEIWBE firms. "Bidder must circle or otherwise notate which of the two (2) required actions were performed. Attached GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/WBEs, )aper Ad including providing such MBE/WBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S). The bidder selected specific portions of the work to be performed by MBE/WBEs in order to increase the likelihood of meeting the MBEIWBE goals (including breaking down contracts into smaller units to facilitate MBEIWBE participation) CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE/WBE was unqualified to perform the job. *Proper demonstration of Good Faith Effort requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. LAMR159 M#11711iff?ZOVA Contractor's Bid for Public Works - 10 &'gyp CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-2.1 MBEIWBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. PAGE OF Project Number: I 16-108 Project Name: Erskine Clubhouse Rernodelin MBE/WBE Participation Goal Bidder' w 7iolkosld Copstruction, Inc. By: Bill Favors, President August 14, 2 01, 8 (Signature) (Title) (bate) Owner or Contact at MBEIWBE Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE/WBE FIRM: XWWW"02=21771, Owner or Contact at MBEIWB,E Firm Telephone: Fax: Email: TYPE OF WORK SOLICITED FOR THIS PROJECT: RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Version 10/17/2017 Contractor's Bid for Public Works - 11 A0 -[A OTM L,-m- Document A,31 - 20111 CONTRACTOR: (Name, legal stains and address) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, Indiana 46,628 OWNER: (Alamo, legal status and address) City of South Bend, Board of Public Works 227 West Jefferson Boulevard South Bend, Indiana 46601 BOND AMOUNT: SURETY: (yVante, legal status and principal place of business) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 Five Percent of Accompanying Bid (5% of Accompanying Bid) PROJECT: (Name, location or address, and Project nuinber, if any) Erskine Clubhouse Renovation, Project No. 116-108 South Bend Venues, Parks & Arts This document has important legal consequences. Consultation with an afforney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the tennis of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful perforinance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified hi said bid and such larger amount for which the Owner may in good faith contract with another party to perform the wor]k covered by said bid, then this obligation shall be null and void, oflicnvise to remain in fidl force and effect. 'The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in w1lich the Owner may accept the bid. Waiver of notice by the Surely shall not apply to any, extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for ail extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to, a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutot3, or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted here-froin and provisions conforming to such statutory or other legal requirement s1lall be deemed incorporated herein. When so furnished, the intent is that this Bond sliall be construed as a statutory bond and not as a common law bond. Signed and scaled this 24th day of July, 2018 (T'FitneSS) Sleannon Reidenbach tness) 'Johrr". Johnson Ziolkowski Construction, Inc. (Seal) (778e) Bill Favors, President Liberty M ituat Insurance Cq1m]!).pan (s, =( (Seal) Adrienne C. Stevenson, Attorney d In Fact State of IL County of DuPage ss: On July 24, 2018 , before me, a Notary Public in and for said County and State, residing therein, duly con itnissioned and sworn, personally appeared Adrienne C. Stevenson known to me to be Attorney -in -Fact of Liberty Mutual Insurance Company the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument in behalf of the said corporation, and he duly acknowledged to me that such corporation executed the same, IN WITNESS W1HFREOF, I have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above, A My Commission Expires 6/8/2020 Lk G. R. 7rqanclez Notary Public C R HERNANDEZ , I Offi6al Seal Notary Public - State of Illinois 'no's MY Cornniission Expires Jun 8, 2020 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Not valid for mortgage, note, loan, letter of credit, bank deposit, currency rate, Interest rate or residual value guarantees. To confirm the validity of this Power of Attorney call 610.832.8240 between 9:00 am and 4:30 pm EST on any business day. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American insurance Company is a corporation duly organized under the laws of the Stale of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Adrienne C. Stevenson of the city of. _ Chicago _ stale of Illinois its true and lawful attomey-in-fact, with full power and authority hereby conferred to sign, execute and acknowledge the following surety bond: Principal Name: Ziolkowski Construction Inc Obiigee Nama: _._Cif of South Bend IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 2711, day of February, 2017. �iNSUR A�,1,1INSUR NINSV,?4 aJ� pHPQI�T'1`�� ��'�i�aL04lPORgy�'i'f� �tpRPU1���(`F, 1912 1919 01991 a ACH05 1� ��!'NAMPS �h= �NDIANP STATE OF PENNSYLVANIA COUNTY OF MONTGOMERY The Ohio Casualty Insurance Company Liberty Mutual Insurance Company 9Wes merican Insurance Company QH1 David MCarey, Assistant Secretary On this 270 day of February 2017 _before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of , Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. COMMONWEALTH OF PENNSYLVANIA Notarial Seel Teresa Pastolla, Notary Public gy, Upper Marion Twp., Monipomery Co mty Teresa Pastella, otary Public My Commission Expires March 28, 2021 e Member, Pennsylvania Association of Notaries This Power of Attorney is made and executed pursuant to and by authority of the following Bylaws and Authorizations of, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV — OFFICERS — Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such atterneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney - in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts — SECTION 5. Surely Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations, Such afto€neys-in-fact subject to the limitations set forth in their respeclive powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as 4 signed by the president and atlesled by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys - in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed, I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of The Ohio Casualty insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this PLIN5U,? �pV11INSUR �NVNSUgt� �h �LPRPOIj,Pr N�.^ GQ4 �L04:40r�T°`LrC' �w�`CpRPOf 7A,�Cs"O � ° n Y 1912 ° 1919 1991 ro )y� ,{�' o y, ab a .� sSACWVSG tom' yy+(HAMPS�` 1= 3 �NCJIAS:A t. 24th day of July 2018 By: Renee C. Llewellyn, Assistant Secretary SECTION I EXPERIENCE QUESTIONNAIRE 1. What public works projects has your organization completed for the period of one (1) year prior to the date of the current bid? Contract Amount Class of Work Completion ©ate Name and Address of Owner $27,366,910 General 05/2016 Purdue University North Central $21,355,975 General 06/2015 Armed Forces Reserve Center $9,020,000 General 10/2016 South Bend Airport- New Arrivals Term $15,464,580 General 12/2016 Renaissance District - Phase I 2. What public works projects are now in process of construction by your organization? Contract Amount Class of Work Expected Completion Date Name and Address of Owner $6,528,402 General 6/2018 UND Walsh Hall Selective Renovations $5,139,150 General 8/2018 ' Laporte High School - Performing Arts C $13,208,000 General 8/2019 laporte Intermediate on the Kesling Cam $3,472,000 General 8/2018 PHM Schools - Football Stadium Improv al nter is meats 3. Have you ever failed to complete any work awarded to you? No If so, where and why? 4. List references from private firms for which you have performed work. University of Notre Dame, Tony Polotto, LEER, AP, 200 Facilities Bldg., Notre Dame, IN 46556 574-631-4200 City of Mishawaka, Ken Prince, 600 East Third Street, Mishawaka, IN 574-258-1625 Fetters Construction Inc., Steven A. Fetters, 5417 County Rd 427, Auburn, Indiana 46706 260-927-8516 Memorial Hospital & Health System, Larry Lies, 615 N Michigan St., South Bend, IN 46601 574-647-1000 South Bend T I ',IRIBUNE The voice that connects us, 0 "elpt- Date: 07/05/18 Account #: 135334 Company Name: ZOLKOWSKI CONSTRUCTION INC. Contact: Address: 4050 RALPH JONES, DRIVE City: SOUTH BEND State: IN Telephone: (999) 287-1:811 Ad ID: Ruin Dates: Ad Class: Columns wide: Total # of Lines". Total Cost: Account Rep: Phone # Email: Payments: Method Card Type 505048 07/18/18 to 07/20/1,8 Other Legals 1 17 $85.68 Susan Mahoney (574)1235-6216 legals@sbtinfo,com Publications: South Bend Tribune SB Online Last 4 1 Check Arnount Gross., Q$wm Paid Amount: - $0.00 Amount Due: 4$0@M Seeking IVIBE/WBE Business- es: Actively seeking bids frorn certified MBEANBE businesses in several construction trades to participate in the construction ol Erskine Clubhouse Renovation project located rn South Bend, Indiana. Bid date is July 24, 2018. Plans are available in our planroorn website (wwwzplan- roorn.corn). If questions arise, please contact Shannon at Zii 01-i CONSTRUCTION, INC, at 574-287-1811 ext. 271 OT in person at 4050 Ralph Jones Drive, South Bend. i 3t 7:18-20 -A ddft, dutn'(01, Date: June 27, 2018 To: All Bidders and others to whom Plans & Specifications have been issued From: Kil Architecture/ Planning Gregory A. Kil, AIA, NCARB Architect RE: Erskine Clubhouse Renovation, Project 116-108 For City of South Bend, Venues, Parks & Arts 4200 Miami Street South Bend, IN 46614 This addendum forms part of the Contract Documents and modifies the original Bidding Documents only as noted below. The remainder of the drawings and Specifications are to remain in their entirety. Acknowledge receipt of this addendum in the space provided on the Bid Form. This addendum consists of the following changes identified in bold: PROJECT MANUAL: A. Notice to Bidders 1 In the first paragraph omit the words "until the hour of 9:30, a.m., Local Time, on July 1 0 th 2018" and substitute the following words "until the hour of 9:30 a.m., Local! Time, on July 24th, 2018". DRAWINGS: None ATTACHMENTS: K I L ARCHITECTURE PLANNING Addendum #1 page I 1126 LINCOLNWAY EAST SOUTH BEND I N 46601 (574) 288.2654 VOICE 289. 2420 FA X Date: July 19, 2018 To: All Planholders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 2 Project Name: Erskine Clubhouse Renovation Project Number: 116-108 Date Received: / � o / I S- This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt.A copy MUST also be included with your bid package upon submittal. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. ' Company: Z f C) tc� �'s k4l Authorized Signature: t- -4 Date: Version 4/2/2015 Date: July 20, 20 18 To: All Planholders From Linda M. Martin, Clerk, Board of Public Works Subject Addendum Number: 3 Project Name: Erskine Clubhouse Renovation Project Number: 116-108 Date Received: This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Authorized Signature: Date: I I rkc) ('1111) --- Version 4/2/2015 Date: To: From Subject August 8, 2018 All Planholders Linda M, Martin, Clerk, Board of Public Works Addendum Number: 4 Project Name: Erskine Clubhouse Renovation Project Number: 116-108 Date Received: This addendum is being forwarded to you for the above referenced project. Please sign below and acknowledge receipt of this Addendum by faxing this sheet to the Board of Public Works at (574) 235-9171 within 48 hours of receipt. A copy MUST also be included with your bid package upon submittal. WOMINIVIIII Ill I � I] 11,11111-CHINTO., Notes: The attached documents are hereby added to the Specifications and Contract Documents and become a part of herein. Company: Authorized Signature: Date: Version 4/2/20 15 l WNW t-,, 11 rfi-lt, ry- b Company ID Number: 486671 THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE I PURPOSE AND AUTHORITY This Memorandum of Understanding (MOU) sets forth the points of agreement between the Department of Homeland Security (DHS) and _2iolkawski Construction? Inc. (Employer) regarding the Employer's participation in the Employment Eligibility Verification Program (E- Verify). This MOU explains certain features of the E-Verify program and enumerates specific, responsibilities of DHS, the Social Security Administration (SSA), and the Employer. E-Verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E-Verify is used to verify the employment eligibility of all newly hired employees and all existing employees assigned to Federal contracts or to verify the entire workforce if the contractor so chooses. Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as a "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive Order 12989, as amended. ARTICLE 11 FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available information that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorization of U.S. citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E-Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E-Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E-Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E-Verify program or such other persons or entities who may be authorized by SSA as governed Page 1 of 13 1 E-Verify MOU for Employer I Revision Bate 09/01/09 wmv.dits.govlE-Verify Q� Company ID Number: 486671 To' be accepted as a participant in E-Verify, you should only sign the Employer's Section of the signature page. If you have any questions, contact E-Verify at 888-464-4218. Employer Ziolkowski Construction, Inc. Bill Favors Name (Please Type or Print) Electronically Signed Title 1/10/2012 Signature Date Department of Homeland Security — Verification Division SCIS Verification Division Name (Please Type or Print) Electronicall Signed itle 01/10/2012 Signature Date Information Required for the E-Verify Program Information relating to your Company: Company Name: iolkowskl Construction, Inc. Company Facility Address: 4050 Ralph Jones Dr. South Bend, IN 46628 Company Alternate Address: County or Parish: STJOSEPH Employer Identification Number: P51446992 Page 12 of 13 1 E-Verify NOU for Employer I Revision Date 09/01/09 www.dhs.gov/E®Verify � cr�rc�ssru:n:s oon .� Company ID Number: 486671 North American Industry Classification Systems Code: 36 Administrator: Number of Employees- 100 to 499 Number of Sites Verified for: 1 Are you verifying for more than I site? If yes, please provide the number of sites verified for in each State: o MUNA 1 site(s) . -information relating to -tire Program Administrator(s) for your Company on policy questions or operational problems: Name: James Keldsen Telephone Number: (574) 287 -1511 ext. 368 Fax Number: (574) 344 - 5533 E-mail Address: ,jkeldsen(uzbuiid.com Page 13 of 13 1 E-Verify MOU for Employer I Revision Daie 09/01/09 wnmw.dhs.gov/E-Ver1fy 6/12/2017 E Verify: Employer Wizard- Company Information E-veriFy, Welcome James Keidsen Company Information Company Name Ziolkowski Construction, Inc. ' i Companyl©Number 486671 Doing Business As (ODA) Name DUNS Humber Physical Location Address 1 4050 Ralph Jones Dr. Address 2 CRY South Bend state i IN Zip Code i 46628 County STJOSEPH Mailing Address Address 1 Address 2 City State Zip Code Additional Information Employer Identification Number 351446992 Total Number of Employees 100 to 499 Parent Organization Administrator i— Organization Designation Employer category None of these categories apply View! Edit i NA1CScode 236 - CONSTRUCTION OF BUILDINGS View ! Edit Total Hiring Sites httpsJ/e-verify.uscis.govlweblEmployerW izard.aspx MENU